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Nonprofiteer
← UKIAH ADVENTIST HOSPITAL

Form 990 for tax year 2023

Filed by UKIAH ADVENTIST HOSPITAL.

Totals

Total revenue
$261,487,354
Total expenses
$256,662,020
Contributions and grants received
$3,253,922
Grants paid
$249,848
Program service revenue
$255,410,857
Investment income
$2,822,575
Other revenue
$0
Total assets, end of year
$261,031,343
Total liabilities, end of year
$105,934,809
Net assets or fund balances, end of year
$155,096,534
Program services expenses (Part IX)
$212,602,177
Management and general expenses
$43,856,427
Fundraising expenses
$203,416
Program service expenses (Part III)
$212,602,177

Program services were 82.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Heinrich Kerry

    Dir/Chair/CEO

    Total calculated
    $3,359,823
    From this org
    $0
    From related orgs
    $3,302,428
    Other
    $57,395
    Hours/week
    0 + 50.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $2,017,000 related
    Bonus
    $0 + $1,208,880 related
    Other
    $0 + $76,548 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $44,099 related
    Filer's total
    $0 + $3,359,823 related

  • Hofheins Todd

    Dir/Vice Chair/COO

    Total calculated
    $2,348,733
    From this org
    $0
    From related orgs
    $2,272,592
    Other
    $76,141
    Hours/week
    0 + 50.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,389,462 related
    Bonus
    $0 + $735,265 related
    Other
    $0 + $147,865 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $62,845 related
    Filer's total
    $0 + $2,348,733 related

  • Beaman John

    CFO/Assistant Secretary

    Total calculated
    $1,753,908
    From this org
    $0
    From related orgs
    $1,680,553
    Other
    $73,355
    Hours/week
    0 + 50.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,091,769 related
    Bonus
    $0 + $569,149 related
    Other
    $0 + $19,635 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $60,059 related
    Filer's total
    $0 + $1,753,908 related

  • Stevens Eric - President

    Northern CA/HI State Network

    Total calculated
    $1,585,845
    From this org
    $0
    From related orgs
    $1,526,293
    Other
    $59,552
    Hours/week
    5 + 45.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,045,616 related
    Bonus
    $0 + $319,995 related
    Other
    $0 + $160,682 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $46,256 related
    Filer's total
    $0 + $1,585,845 related

  • Jahn Andrew - Former

    Care Division President thru 02/22

    Total calculated
    $1,569,691
    From this org
    $0
    From related orgs
    $1,465,906
    Other
    $103,785
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,044,420 related
    Bonus
    $0 + $406,990 related
    Other
    $0 + $14,496 related
    Deferred
    $0 + $53,160 related
    Nontaxable benefits
    $0 + $50,625 related
    Filer's total
    $0 + $1,569,691 related

  • Nahapetian Arby - Former Care

    Division Medical Officer thru 02/22

    Total calculated
    $1,551,907
    From this org
    $0
    From related orgs
    $1,482,294
    Other
    $69,613
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $967,385 related
    Bonus
    $0 + $329,621 related
    Other
    $0 + $185,288 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $56,317 related
    Filer's total
    $0 + $1,551,907 related

  • Wells Jason

    Former President thru 12/20

    Total calculated
    $1,507,759
    From this org
    $0
    From related orgs
    $1,470,582
    Other
    $37,177
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $892,808 related
    Bonus
    $0 + $337,640 related
    Other
    $0 + $240,134 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $23,881 related
    Filer's total
    $0 + $1,507,759 related

  • Wing Bill - Former

    Dir/Asst Secr/Vice Chair thru 01/22

    Total calculated
    $1,478,533
    From this org
    $0
    From related orgs
    $1,438,460
    Other
    $40,073
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $1,438,460 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $26,777 related
    Filer's total
    $0 + $1,478,533 related

  • Jobe Meredith

    Secretary

    Total calculated
    $1,018,898
    From this org
    $0
    From related orgs
    $959,488
    Other
    $59,410
    Hours/week
    0 + 50.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $660,525 related
    Bonus
    $0 + $168,715 related
    Other
    $0 + $130,248 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $46,114 related
    Filer's total
    $0 + $1,018,898 related

  • Howe Judson - President AHUV

    Pres, North Coast Network thru 03/23

    Total calculated
    $837,892
    From this org
    $0
    From related orgs
    $808,895
    Other
    $28,997
    Hours/week
    8.3 + 41.7 related

    Schedule J breakdown matched by us

    Base
    $0 + $538,154 related
    Bonus
    $0 + $186,337 related
    Other
    $0 + $84,404 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $15,701 related
    Filer's total
    $0 + $837,892 related

  • Tetz Warren - Former

    Treas/Asst Secr thru 12/22

    Total calculated
    $618,860
    From this org
    $0
    From related orgs
    $560,025
    Other
    $58,835
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $17,731 related
    Bonus
    $0 + $125,629 related
    Other
    $0 + $416,665 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $45,539 related
    Filer's total
    $0 + $618,860 related

  • Spencer Lindsey - Former

    Operations Executive thru 05/22

    Total calculated
    $616,196
    From this org
    $0
    From related orgs
    $564,751
    Other
    $51,445
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $450,442 related
    Bonus
    $0 + $59,341 related
    Other
    $0 + $54,968 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $38,149 related
    Filer's total
    $0 + $616,196 related

  • Eberhart Gregory

    Area Medical Officer

    Total calculated
    $610,905
    From this org
    $0
    From related orgs
    $582,946
    Other
    $27,959
    Hours/week
    12.5 + 37.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $516,674 related
    Bonus
    $0 + $19,931 related
    Other
    $0 + $46,341 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $14,663 related
    Filer's total
    $0 + $610,905 related

  • Spenst Brett - Former Care

    Division Finance Officer thru 02/22

    Total calculated
    $566,472
    From this org
    $0
    From related orgs
    $520,625
    Other
    $45,847
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $259,692 related
    Bonus
    $0 + $250,809 related
    Other
    $0 + $10,124 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $32,551 related
    Filer's total
    $0 + $566,472 related

  • Van Housen Heather

    Former Patient Care Exec thru 09/18

    Total calculated
    $550,119
    From this org
    $0
    From related orgs
    $478,454
    Other
    $71,665
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $361,260 related
    Bonus
    $0 + $70,116 related
    Other
    $0 + $47,078 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $58,369 related
    Filer's total
    $0 + $550,119 related

  • Mock Jeffrey

    Treasurer/Asst Secr as of 09/23

    Total calculated
    $538,188
    From this org
    $0
    From related orgs
    $470,391
    Other
    $67,797
    Hours/week
    10 + 40.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $344,451 related
    Bonus
    $0 + $53,131 related
    Other
    $0 + $72,809 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $54,501 related
    Filer's total
    $0 + $538,188 related

  • Shepardson Dean - Treasurer

    Asst Secr from 03/23 thru 09/23

    Total calculated
    $517,604
    From this org
    $0
    From related orgs
    $461,843
    Other
    $55,761
    Hours/week
    12.5 + 37.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $307,500 related
    Bonus
    $0 + $25,000 related
    Other
    $0 + $129,343 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $42,465 related
    Filer's total
    $0 + $517,604 related

  • Assadian Hoda

    Operations Executive

    Total calculated
    $513,302
    From this org
    $0
    From related orgs
    $460,925
    Other
    $52,377
    Hours/week
    16.7 + 33.3 related

    Schedule J breakdown matched by us

    Base
    $0 + $329,595 related
    Bonus
    $0 + $101,331 related
    Other
    $0 + $29,999 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $39,081 related
    Filer's total
    $0 + $513,302 related

  • Bartolomie Jill

    Patient Care Executive

    Total calculated
    $474,427
    From this org
    $0
    From related orgs
    $385,649
    Other
    $88,778
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $284,196 related
    Bonus
    $0 + $41,572 related
    Other
    $0 + $59,881 related
    Deferred
    $0 + $13,296 related
    Nontaxable benefits
    $0 + $75,482 related
    Filer's total
    $0 + $474,427 related

  • Leighton David

    Administrator

    Total calculated
    $402,874
    From this org
    $375,015
    From related orgs
    $0
    Other
    $27,859
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $233,126
    Bonus
    $109,400
    Other
    $32,489
    Deferred
    $14,819
    Nontaxable benefits
    $13,040
    Filer's total
    $402,874

  • Winter Carrie

    Multi-Site Director Pharmacy

    Total calculated
    $372,228
    From this org
    $316,233
    From related orgs
    $0
    Other
    $55,995
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $258,413
    Bonus
    $25,150
    Other
    $32,670
    Deferred
    $11,644
    Nontaxable benefits
    $44,351
    Filer's total
    $372,228

  • Woodruff Nicole

    Director, Perioperative Services

    Total calculated
    $355,075
    From this org
    $312,439
    From related orgs
    $0
    Other
    $42,636
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $237,554
    Bonus
    $42,735
    Other
    $32,150
    Deferred
    $10,884
    Nontaxable benefits
    $31,752
    Filer's total
    $355,075

  • Denoeu Rebecca

    Director, Emergency Services

    Total calculated
    $353,413
    From this org
    $291,427
    From related orgs
    $0
    Other
    $61,986
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $239,710
    Bonus
    $21,454
    Other
    $30,263
    Deferred
    $10,084
    Nontaxable benefits
    $51,902
    Filer's total
    $353,413

  • Newman Honalee

    Director, Diagnostic Imaging

    Total calculated
    $317,234
    From this org
    $294,703
    From related orgs
    $0
    Other
    $22,531
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $196,865
    Bonus
    $73,277
    Other
    $24,561
    Deferred
    $9,180
    Nontaxable benefits
    $13,351
    Filer's total
    $317,234

  • Byrnes John - Former

    Medical Officer, NCR thru 02/20

    Total calculated
    $298,614
    From this org
    $0
    From related orgs
    $263,659
    Other
    $34,955
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $263,659 related
    Deferred
    $0 + $13,183 related
    Nontaxable benefits
    $0 + $21,772 related
    Filer's total
    $0 + $298,614 related

  • Parker Bessant - Former

    Area Medical Officer thru 03/22

    Total calculated
    $264,256
    From this org
    $0
    From related orgs
    $211,890
    Other
    $52,366
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $211,890 related
    Deferred
    $0 + $10,594 related
    Nontaxable benefits
    $0 + $41,772 related
    Filer's total
    $0 + $264,256 related

  • Freedman John

    Director

    Total calculated
    $26,770
    From this org
    $0
    From related orgs
    $26,770
    Other
    $0
    Hours/week
    0 + 4 related

  • Cherry Robert

    Director

    Total calculated
    $26,611
    From this org
    $0
    From related orgs
    $26,611
    Other
    $0
    Hours/week
    0 + 4 related

  • Davis Andrew

    Director

    Total calculated
    $26,611
    From this org
    $0
    From related orgs
    $26,611
    Other
    $0
    Hours/week
    0 + 4 related

  • Innocent Larry

    Director

    Total calculated
    $26,611
    From this org
    $0
    From related orgs
    $26,611
    Other
    $0
    Hours/week
    0 + 4 related

  • Newton Bradford

    Director

    Total calculated
    $26,611
    From this org
    $0
    From related orgs
    $26,611
    Other
    $0
    Hours/week
    0 + 4 related

  • Reiner Richard

    Director

    Total calculated
    $26,611
    From this org
    $0
    From related orgs
    $26,611
    Other
    $0
    Hours/week
    0 + 4 related

  • Salazar Velino

    Director

    Total calculated
    $26,611
    From this org
    $0
    From related orgs
    $26,611
    Other
    $0
    Hours/week
    0 + 4 related

  • Banks David

    Director

    Total calculated
    $26,181
    From this org
    $0
    From related orgs
    $26,181
    Other
    $0
    Hours/week
    0 + 4 related

  • Woodson Marc

    Director

    Total calculated
    $21,611
    From this org
    $0
    From related orgs
    $21,611
    Other
    $0
    Hours/week
    0 + 4 related

  • Wagner Jack

    Director

    Total calculated
    $16,180
    From this org
    $0
    From related orgs
    $16,180
    Other
    $0
    Hours/week
    0 + 4 related

  • Fehr Joy

    Director

    Total calculated
    $430
    From this org
    $0
    From related orgs
    $430
    Other
    $0
    Hours/week
    0 + 4 related

  • Ocampo Lucy

    Director thru 08/23

    Total calculated
    $0
    Hours/week
    0 + 4 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Part I, Lines 4a-b
Severance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Byrnes, John - severance payment - $262,731 Parker, Bessant - severance payment - $212,500 Tetz, Warren - severance payment - $416,673 Wing, Bill - severance payment - $1,440,800 Select executives agreed to participate in CAP-EX in place of a traditional insurance SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Brett Spenst, Jack Wagner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2023

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2023
Filed
1 November 2024
IRS schema version
2023v5.1
Source object
202443109349303094

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